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Should Everyone Over 65 Take a Statin?

Should Everyone Over 65 Take a Statin?

WEDNESDAY, Aug. 28 (HealthDay News) -- Men and women over 65 who are at risk for cardiovascular disease but don't have any known heart problems might benefit from cholesterol-lowering drugs, a new study suggests.

The researchers said statins such as Crestor and Lipitor can reduce the risk of heart attack and stroke, although they don't seem to prevent death from cardiovascular disease or other causes over the short term.

"This is the first time the benefit of these drugs has been demonstrated in this population of patients," said senior study author Dr. Pasquale Perrone-Filardi, from the department of advanced biomedical sciences at Federico II University in Naples, Italy.

These findings fill a gap in current guidelines, Perrone-Filardi said. To date, there has been no firm evidence that statins benefit patients who haven't had a heart attack or stroke, he said. There also has been no evidence showing the benefits of using the drugs for what is known as primary prevention.

"[This new data] would not [make me] recommend statins for all older patients, but maybe for patients with hypertension or atherosclerosis," Perrone-Filardi said.

For the new study, Perrone-Filardi's team reviewed data from eight previously published trails that included nearly 25,000 participants. These patients were at risk for cardiovascular disease but hadn't had a previous heart attack or stroke.

This type of study, called a meta-analysis, attempts to find common patterns in data from several unrelated trials.

In these trials, which compared statins and placebos in patients followed for an average of three and a half years, statins reduced the risk of heart attack by about 29 percent and stroke by nearly 24 percent, the researchers found.

In terms of preventing death from any cause, however, statins did not have an effect, the researchers said.

Despite the new findings, Perrone-Filardi doesn't think everyone over 65 should be taking statins. The patients who benefit are those with a high risk for cardiovascular disease, he said.

"The problem is that age is one of the main risk factors for cardiovascular disease, so it's difficult to detect among a population of old people who are the patients at very high cardiovascular risk," he said.

The study, which did not receive any drug-company or other outside funding, was published Aug. 28 in the Journal of the American College of Cardiology.

In the United States, guidelines already recommend statins for primary prevention of heart attack and stroke, an expert said.

"Statins have been proven to substantially reduce fatal and nonfatal cardiovascular events in individuals without known cardiovascular disease, even among men and women with cholesterol levels considered in the normal range," said Dr. Gregg Fonarow, a spokesman for the American Heart Association.

Guidelines in the United States recommend statin therapy for primary prevention in men and women regardless of age. The guidelines from the European Society of Cardiology, however, do not provide recommendations for statin use in older people, Fonarow said.

The benefits of statins outweigh their risks for primary prevention in the clinical trials conducted so far, said Fonarow, a professor of cardiology at the University of California, Los Angeles.

"As cardiovascular disease remains the leading cause of death, disability and health care expenditures among men and women age 65 years or older -- and most men and women in this age range are at intermediate or high risk for cardiovascular events -- statins, together with a healthy diet and regular exercise, represent one of the most effective ... strategies for individual and population-level cardiovascular health," Fonarow said.

Cost is a consideration for any drug taken regularly. An April 2012 issue of Consumer Reports noted that statins vary widely in cost -- anywhere from $12 to more than $500 each month. The article, however, listed generic statins that can cost just a few dollars a month when supplied through programs run by major chain stores.

More information

For more about statins, visit the U.S. National Library of Medicine.

SOURCES: Pasquale Perrone-Filardi, M.D., Ph.D., department of advanced biomedical sciences, Federico II University, Naples, Italy; Gregg Fonarow, M.D., spokesman, American Heart Association, and professor, cardiology, University of California, Los Angeles; April 22, 2012, Consumer Reports Health Best Buy Drugs: Statin Drugs to Treat High Cholesterol and Heart Disease; Aug. 28, 2013, Journal of the American College of Cardiology

 
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  Stroke Prevention for Women: Start Early
  Study Questions Use of Beta Blockers Before Heart Bypass Surgery
  High Blood Pressure May Sometimes Be Overtreated: Study
  Vitamin D: A Key to a Longer Life?
  New Blood Test May Help Detect Heart Transplant Rejection
  Rising Stroke Rate for Blacks in South Carolina, Study Finds
  People With Heart Disease, Diabetes May Be More Likely to Stay on Statins
  Antidepressants in Pregnancy Won't Harm Baby's Heart, Study Suggests
  Rare Gene Mutations May Help Shield the Heart
  Depression Doubles Odds of Heart Attack for Younger Women: Study
  Testosterone Products Must Warn About Risk of Venous Clots: FDA
  Quitting Smokeless Tobacco May Boost Survival After Heart Attack
  Screen Older Men Who've Ever Smoked for Aneurysms: Experts
  Heart Failure Therapy May Benefit Women More Than Men
  After Stroke, Spouse May Also Need Care
  Heart Monitoring May Prevent Some Strokes, Study Suggests
  Nursing Home Care May Be Out of Reach for Many Aging 'Boomers': Study
  Latest Study Finds No Link Between Testosterone Supplements, Heart Attack
  Ecstasy Use Tied to Rare Spinal Blood Vessel Problem in Teen
  Could Dark Chocolate Help Ease Poor Leg Circulation?
  Experts Reject Routine Screening for Narrowed Neck Arteries
  Poor More Prone to Leg Circulation Trouble
  Cholesterol Levels May Be Linked to Breast Cancer Risk
  Older Adults Can Safely Donate a Kidney, Study Finds
  Severe Obesity Cuts Up to 14 Years Off Life: Study
  More Painkillers May Raise Heart Risks for Older Women: Review
  Even Moderate Drinking Might Raise Odds for Irregular Heartbeat
  A Little Alcohol May Not Be Good for Your Heart After All
  Don't Judge a Pill by Its Color
  Stress, Depression May Boost Stroke Risk, Study Finds
  Potassium Supplements May Help Some Heart Failure Patients
  Surgery Soon After Stroke Can Be Risky: Study
  Stroke Rates Declining Among Seniors, Study Shows
  Is Obesity an Advantage After Heart Procedures?
  Scientists Use Gene Therapy to Create 'Biological Pacemaker' in Pig Hearts
  Niacin Doesn't Reduce Heart Problems, May Create Some, Research Finds
  Childhood Sex Abuse May Be Linked to Heart Disease Risk in Women
  Irregular Heart Rhythm Ups Stroke Risk Soon After Heart Surgery
  Life Skills, Parenting Classes May Cut Inflammation in Poor Kids
  Waistlines of U.S. Kids Seem to Be Holding Steady, Study Finds
  No Change in Heart Attack Rates for Younger U.S. Adults
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  Anomalous Coronary Artery (ACA)